NPI | 1124651708 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1028932) |
Additional Taxonomies | 163WP2201X Registered Nurse, Ambulatory Care (Licence: TX 930646) |
363L00000X Nurse Practitioner (Licence: LA 221572) | |
Enumeration Date | 2020-02-21 |
Last Update Date | 2023-04-26 |